收肌管阻滞与关节腔周围注射在膝关节置换术后的镇痛效果比较  

Comparison of Analgesic Effect Between Myocardium Block And Periarticular Injection After Knee Joint Replacement

作　　者：王疆 殷积慧[2] WANG Jiang;YIN Ji-hui(Subject Two,Department of Anesthesiology,Linyi Traditional Chinese Medicine Hospital,Linyi 267002,Shandong,China;Affiliated Hospital of Shandong University Medical College,Qingdao 266003,Shandong,China)

机构地区：[1]山东临沂市中医医院麻醉二科,山东临沂267002 [2]山东青岛大学医学院附属医院,山东青岛266003

出　　处：《医学信息》2019年第7期123-125,共3页Journal of Medical Information

摘　　要：目的对膝关节置换术(TKA)实行超声引导下收肌管阻滞(U-ACB),观察其镇痛效果。方法选取我院2017年8月～2018年8月收治的80例拟行TKA的患者,随机将其分成对照组和观察组,各40例。对照组患者进行关节周围注射镇痛,观察组采用U-ACB镇痛。比较两组术后6、12、24、48 h股四头肌肌力分级情况、静息和运动时VAS评分情况及不良反应发生情况。结果对照组术后6、12、24、48 h股四头肌肌力评分高于观察组,差异有统计学意义(P<0.05);静息时,对照组术后6、12、24、48 hVAS评分高于观察组,差异有统计学意义(P<0.05);运动时,两组术后6、12、24、48 hVAS评分比较,差异无统计学意义(P>0.05);对照组不良反应发生率高于观察组(15.00%vs 2.50%),差异有统计学意义(P<0.05)。结论 U-ACB有利于TKA术后镇痛效果的提高,安全性较高,值得应用。Objective To observe the analgesic effect of knee-to-articular replacement (TKA) under ultrasound-guided musculoskeletal block (U-ACB). Methods 80 patients with TKA who were admitted to our hospital from August 2017 to August 2018 were randomly divided into control group and observation group, 40 cases each. Patients in the control group underwent analgesia around the joints, and the observation group used U-ACB analgesia. The muscle strength of the quadriceps muscles at 6, 12, 24, and 48 h after operation, the VAS scores at rest and exercise, and the incidence of adverse reactions were compared. Results In the control group, the quadriceps muscle strength scores at 6, 12, 24, and 48 h after operation were higher than those in the observation group (P<0.05). At rest, the control group was 6, 12, 24,48 hVAS after surgery score was higher than that of the observation group,the difference was statistically significant (P<0.05). There was no significant difference in the VAS scores between the two groups at 6, 12, 24, and 48 h after exercise (P>0.05). The incidence of adverse reactions was higher than that of the observation group (15.00% vs 2.50%),the difference was statistically significant (P<0.05). Conclusion U-ACB is beneficial to the analgesic effect of TKA, and it is safe and worthy of application.

关 键 词：收肌管阻滞 关节腔周围注射 膝关节置换 术后镇痛 

分 类 号：R614[医药卫生—麻醉学]